1. Field of the Invention (Technical Field)
The present invention relates to a self-contained, lighted laryngoscope for clearing and visualizing the intubation pathway.
2. Background Art
Health care providers perform direct laryngoscopy to either clear a patient""s airway of debris, or more commonly place a tube into a patient""s trachea to assist or replace a patient""s ability to oxygenate his/her system. The laryngoscope utilizes either a straight or curved blade that allows visualization of the vocal cords, which are the landmarks for locating the opening of the trachea. This lighted blade is used to keep the tongue from obstructing the provider""s view of the vocal cords. The tip of the blade lifts the epiglottis, thereby providing a direct view into the patient""s trachea, and reducing the risk of intubating the esophagus instead. Intubation and blowing air into the stomach is not useful, causes stomach distention and vomiting, and furthermore, unless recognized quickly deprives the patient of much needed oxygen and causes an associated increase in morbidity.
Proper placement of the laryngoscope is often hindered by the presence of blood, saliva, vomit, secretions, or broken teeth in people who have sustained injuries or sickness.
Intubation itself requires two hands. One hand operates the lighted laryngoscope in order to visualize the vocal cords and the opening to the trachea, and the other hand places the tube. In a trauma situation, the patient""s mouth may be filled with the aforementioned debris. Often, another person is required to suction out the debris in the oral cavity. There are numerous ways to handle this urgent situation, all having their own disadvantages. Following are some of the most frequently seen scenarios:
(a) The person must put the tube down, grasp for the suction catheter, clear the airway, place the suction device down into the airway, clearing it, and then regrasp and place the tube. During the process of regrasping the tube, the view of the airway aperture is occasionally lost. The procedure must then be repeated from the beginning, losing valuable time as well as depriving the patient of oxygen. The patient must then be ventilated for 15 to 30 seconds by basic means whereby oxygen is forced through the patient""s nose and mouth into his lungs. Some air also goes into the stomach. Eventually, the stomach becomes so distended by air that it empties through the mouth. This in turn requires constant and aggressive suctioning to allow a clear view down the airway for another attempt at intubation to be made. Each additional attempt causes the patient to further asphyxiate due to hypoxia, or lack of oxygen. Other disadvantages of additional attempts are cosmetic injuries to teeth, gums, and lips. Injuries to these areas increase as the number of attempts increase.
(b) A second health care provider can provide suctioning while the person visualizing the airway maintains his view of the airway aperture. In today""s health care market, personnel cuts often result in shortages of personnel. There may not be a team member available to do this.
(c) Frequently, after repeating this procedure unsuccessfully, health care providers are forced out of necessity to perform an emergency cricothyrotomy. Although a relatively easy procedure, if not performed by skilled personnel with intricate knowledge of the human airway, it can be fatal within seconds. There is also a chance of post-procedure infection.
Several prior art devices have attempted to address some of these shortcomings:
U.S. Pat. No. 4,126,127, to May, entitled xe2x80x9cSuctioning/Oxygenating Laryngoscope Blade,xe2x80x9d discloses a laryngoscope having a suction tube down the side, with a battery-powered light and sighting channel underneath, but not at the suction tip.
U.S. Pat. No. 5,183,031, to Rossoff, entitled xe2x80x9cFiberoptic Intubating Laryngoscope,xe2x80x9d discloses a fiberoptic flexible stylet and suction channel manipulable by a cable attached to a pistol grip. A syringe port is used for the suction or instillation of fluid. The fiber optics stylet is initially placed in the syringe port to view the patient""s larynx for positioning of the laryngoscope. Once correct positioning is established, the fiber optics stylet is withdrawn so that suctioning can occur.
U.S. Pat. No. 5,897,489, to Urbanowicz et al., entitled xe2x80x9cSnap-On Suction Tube For Laryngoscope,xe2x80x9d discloses a suction device with a flexible tip that clips onto a laryngoscope. A battery operates a light through the laryngoscope.
The present invention is a lighted intubating laryngoscope comprising a hand-held end, a suction tip and an suction channel within a casing; and a light source outside the suction channel, the light source activated and operable by a single operator at the hand-held end for providing light to the suction tip while the laryngoscope is intubating a patient. The preferred light source is a flashlight attached to the hand-held end by an adhesive, clamp, shrink wrap, or other attachment means. Preferably, the flashlight is activated by a push button. In the preferred embodiment, the suction channel casing is made of a light-carrying material, such as a transparent material, preferably an engineering plastic material, and most preferably a polycarbonate resin material.
In an alternative embodiment, the light source comprises fiber optics.
In one embodiment, the suction tip comprises a detachable suction tip. This tip may be attached to the suction channel by an adhesive. The suction tip may be made of a light-carrying material and provides diffused light or other type of illumination depending upon the configuration at the suction tip.
The present invention is further directed to a method of providing light to an intubating laryngoscope procedure comprising: providing an intubating laryngoscope comprising a hand-held end, a suction tip and an suction channel within a casing; providing a light source (e.g. flashlight or fiber optics) outside the suction channel, the light source activatable and operable by a single operator at the hand-held end for providing light to the suction tip; and intubating a patient while simultaneously providing the light source to the suction tip.
In one embodiment, there is a detachable tip. The operator selects a detachable tip suitable for the age or size of the patient.